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Competence: Understanding the Member-Led Activity List

The College of Physiotherapists of Alberta is redesigning its Continuing Competence Program. We have sought member opinions as new program concepts and components are introduced. In our latest survey on the proposed Practice Monitoring + Development Design and Activities, self-selected activities were a common theme.

Instead of participating in Reflective Practice Review activities annually, members will participate in one Self-Selected Activity and then report on the impact of participation.

How did the College of Physiotherapists of Alberta come up with the list of activities and categories for the self-selected activity?

Three sources of evidence informed the categories and activities listed under the self-selected activity.

Source 1: An inventory of competence risks and supports from a research review1 on risks and supports to competence in physicians, pharmacists, occupational therapists, and physiotherapists. A risk to competence was any factor that negatively impacts or alters any facet of competence (e.g., condition or state resulting in an impact such as the decline of clinical reasoning etc.). A support to competence was any factor that helps to foster, develop or improve a facet of the competence (e.g., improvement in clinical reasoning associated with participation in a continuing education program, self study or interaction with peers).

Over 900 articles were reviewed and the risk and supportive factors grouped into categories and further described (Table 1: Risks, Table 2: Supports). While most articles pertained to physician practice, 35 dealt with physiotherapists. The physiotherapy articles primarily described supports to competence.

Source 2: Research2 conducted for the College of Physiotherapists of Ontario which examined College-specific data for the risks and supports categories described in Table 1 and 2. This research identified risks to competent physiotherapist practice.

Source 3: Reports from Alberta physiotherapists about the supports they used to improve their practice. Continuing professional development logs from 2002-20053 and Learning Planner and Tracker records4 for Reflective Practice Review 2015 audit were reviewed. The most frequently reported activities physiotherapists use to improve their competence are:

  • Formal learning: attending workshops, courses
  • Informal learning: reading journals/books, reviewing web-based resources or course notes, consulting colleagues, conducting presentations to colleagues
  • Workplace enhancement: developing new workplace protocols

After considering the plethora of and nature of activities discussed in the resources, the member led activity was categorized into the following three categories:

Practice Review and Monitoring

Activities focused on monitoring personal characteristics, knowledge, performance, and practice against defined benchmarks. Information gained helped identify areas for personal or practice improvement as well as ensuring quality practice. Areas for review include:

  • Physiotherapists’ personal competencies
  • Patient care practices
  • Practice environment

Knowledge Building/Translation

Activities focused on acquiring new or expanding explicit fact-based, technical, and systems knowledge.

  • Organized formal instructional events
  • Self–organized knowledge and skill development using informal resources
  • Creating or translating knowledge via research and teaching

Professional Collaboration

Activities focused on professional contributions and collaborative endeavors are often part of the daily work with others in teams and groups. Outcomes of professional collaboration may be difficult to quantify, codify, or measure. Implied and practical knowledge may be exchanged. Participation results in improved individual competence, patient care or health services but the reported benefits will be highly individualized based on the context and one’s perceptions of the experience.

  • Mentoring
  • Supervising students
  • Involvement with or leading change as part affiliation with physiotherapy specific organizations such as the College of Physiotherapists of Alberta, or the Canadian Physiotherapy Association.

The self-selected activity contains an expansive listing for members to choose from to meet the annual renewal reporting requirements. It includes activities Alberta physiotherapists usually undertake to improve competence and therefore should be acceptable to most members.

Questions and feedback can be directed to the Continuing Competence Program competence@cpta.ab.ca, 1-800-291-2782.

Risk Category



Dyscompetence* or differences in performance associated with change(s) in work or professional status, in focus of practice and/or as experienced by new graduates.

International graduate

Dyscompetence or differences in performance associated with health professionals that were educated in a different country than where the study took place.

Lack of clinical exposure/experience

Dyscompetence or differences in performance associated with knowledge/competence gaps in certain clinical areas arising from insufficient volume of procedures and patients with a condition to attain or maintain competence.


Dyscompetence or differences in performance associated with the person’s age, including youth and older age.


Dyscompetence or differences in performance between men and women.

Practice features

Dyscompetence or differences in performance associated with geographical or office features of the practice.

No certification

Dyscompetence or differences in

performance associated with presence/absence of specific specialty certification.


Dyscompetence or differences in performance associated with physical or mental health related issues.


Dyscompetence or differences in performance associated with resources, including people, money and time.

Adequacy of practice or education

Dyscompetence or differences in performance associated with a previous educational program that did not adequately prepare learners with particular skills or with specific knowledge due to brevity or low quality.

Area of speciality/certification

Specialty or certification-based variations in dyscompetence. Certification and specialty are often

used interchangeably.

Previous disciplinary activity

Impact of previous complaint or discipline matter by a regulatory authority, specialty organization or health facility on dyscompetence.


Differences related to risks to competence not included in the higher-volume defined topics.

Support Category


Continuing education participation

Involvement in an educational activity, such as a course, workshop, or conference during the practice competence life-cycle (i.e. post-specialty/program-specific training).

Educational information/program features

Actions or interventions included in a pre-existing educational program that are designed to improve the learning, knowledge translation and application of the material.

Personal support and feedback

Mentorship and feedback provided or available to individuals to inform or improve clinical skills and/or knowledge.

Clinical exposure/experience

Time spent in specific rotations or at specific clinical sites, with a particular patient/client population.

Quality assurance participation

Formal activities within a structured organizational quality assurance program, in the workplace.

Support through structure or organization

Employer or site-specific structures or processes that develop or maintain individual or professional competence.

Professional organization participation/systems

Mandatory participation in formal personal activities to develop or maintain competence as established through regulatory, association, or specialization requirements.


Mechanical or electronic means to develop or maintain competence via simulation, eLearning opportunities and electronic decision-support rules.

Reflection and self-assessment

Approaches to developing or maintaining competence that include introspection, personal analysis and consideration of adequacy of competence or demonstration of competence.

Assessment and feedback through tools

Approaches that employed a specific tool to measure professional competencies, to determine the adequacy of performance and/or to provide information and motivation for improvement.

Performance review

A formal or structured work-based process whereby a practitioner is provided with information on the adequacy of performance and/or provided with information and motivation for improvement. This information is generally formative and intended to assist in performance improvement.


Approaches to developing or maintaining competence not included in other high-volume defined topics.

  1. Glover Takahashi S, Nayer M, St. Amant LMM. Epidemiology of competence: a scoping review to understand the risks and supports to competence of four health professions. BMJ Open 2017;7:e014823. doi: 10.1136/bmjopen-2016-014823
  2. Glover Takahashi, S. Nayer, M., and St. Amant, L. (March 2017). Overview Report: Connecting Theory & Practice: Exploring the Risks & Supports to the Competence of Physiotherapists. College of Physiotherapists of Ontario, Toronto, ON.
  3. Nayer, M., Lowe, A., (September 2007) Review of the continuing competence program 2007. Unpublished report. College of Physical Therapists of Alberta, Edmonton, AB
  4. Lowe, A (August 2015) Insights gained from an analysis of 2013/14 Learning Planner and Tracker submissions. Unpublished report. Physiotherapy Alberta College + Association.
  5. Glover Takahashi, S., Nayer, M., and St. Amant, L.M.M., July 13, 2017
    Table 1: Inventory and description of all study variables and the risks and supports to competence identified in the literature. Accessed November 14, 2017 BMJ

Page updated: 20/04/2022